Monash University 2019

Medical, Nepal Pokhara

Goh, Kai XingMy six-week Work the World placement in Pokhara, Nepal was everything I imagined it would be and more.

I wanted the reassurance of having an experienced organisation plan the placement for me. I wanted to learn about healthcare in a developing nation, and see unique or advanced medical conditions I couldn’t see in Australia. And I wanted the chance to do some adventure travel, immersing myself into a new culture!

I was soon on my way to Pokhara: the second-largest city of a small, mountainous yet colourful country.

Whilst sometimes chaotic (especially the traffic), I found Nepal a very safe place full of friendly people and surrounded by breathtaking scenery.

Goh, Kai XingNepal’s oft-quoted claims to fame are “Mount Everest is in Nepal” and “Buddha was born in Nepal”, although Hinduism is more widely practiced by some margin.

I became immediately grateful that I had gone with Work the World.

From the moment I arrived in Kathmandu I had access to Work the World’s support team who looked after us so well. I also had a support network of housemates from around the world.

The support the team provided meant all our energy could be spent on having the adventure of a lifetime.

MY HOSPITAL PLACEMENT

Goh, Kai XingMy placement hospital happened to be the biggest hospital in Pokhara. It was so much bigger and grander than I had imagined. The building seemed to be constructed from marble, and on a clear day the snow-capped Himalayas served as a picturesque backdrop.

“General medicine” is an umbrella term in Nepal. It even includes the ICU. Many of the doctors were from outside of Nepal — places like India, Sri Lanka and Malaysia. English was widely spoken thanks to this.

I joined several ward rounds every day — each consultant had their own. The rounds were quite brief given their paternalistic style.

This meant I had exposure to plenty of patients who were more than happy to have me around, especially after a friendly namaste.

Goh, Kai XingOne of the most striking differences in healthcare was the reliance of patients on their families and friends otherwise known as their ‘patient party’.

The patient party are responsible for bringing prescribed medications to patients, taking patients to imaging or endoscopy, even bringing food and performing personal care.

As a result patients’ families slept all around the hospital — in the corridors, in the patients’ rooms, even under patients’ beds.

A hospitalised family member is a costly experience for the average Nepali household. It was hard to observe one family’s financial situation dictating whether or not the doctor could intubate their loved one.

I saw many medical conditions which were very different from those in Melbourne. These included typhoid fever, tuberculosis and rheumatic heart disease.

Goh, Kai XingThe Nepali doctors had a perception that Australia was abundant with deadly snakes. But it was in Nepal that I saw the first case of a snake bite I’d ever seen. I probably saw more than twenty cases while I was there.

I interpreted impressive scans of huge lung and brain abscesses, auscultated unusual murmurs and interpreted fascinating ECGs.

I even had opportunities to observe and assist with procedures including lumbar punctures, central venous catheter insertions and ascitic taps. It’s important to note that I was supervised at all times and working within my scope of practice.

By the end of my placement, I had gained a real insight into the health issues in Nepal.

Goh, Kai XingI saw a lot, but there were also things I did not see. Interestingly, I didn’t come across a single victim of crime and the oncology ward was empty. A Nepalese friend with a master’s degree in public health also proudly informed me that tobacco smoking is barely an issue these days.

However, infections, snake bites, suicide attempts and alcohol dependence were prevalent. This was also the case for conditions related to hypertension (systemic and portal) such as intracranial and variceal bleeds.

THE VILLAGE WEEK

Goh, Kai XingI chose to spend the third week of my trip living with a family in a rural Nepalese village.

Our hosts welcomed us into their homes, and we ate delicious food every day.

Naturally, the trek to and from the community health post was hilly, but the beautiful views of green mountainous expanse made it worth it.

Experiencing healthcare in a rural village was eye-opening.

It was sometimes difficult to tell who was and who wasn’t a patient. Some people seemed to visit the health post for a bit of socialising.

Goh, Kai XingFor ages, visitors chatted in Nepali to the health assistants before finally announcing “blood pressure check!”

Antibiotics were dished out — free of charge — at an alarmingly high rate. I took comfort knowing that were a superbug to develop, it would find it difficult to spread given how remote the village was.

In the afternoons we dressed in traditional dress, learned how to make traditional chapati bread, learned to cut grass with a scythe and how to grind corn by hand.

THE TRAVEL PART

Goh, Kai XingPokhara was the perfect destination for travel as there was so much to do nearby. It was very safe as well, even when on your own or in a small group.

In the afternoons, we walked to Lakeside (the backpacker district) where we shopped, got massages and facials, practiced yoga and meditation, ate at yummy restaurants, and enjoyed beautiful views of the iconic Phewa Lake.

One sunny afternoon we took a boat across the lake and hiked to the top of a hill overlooking the lake to see the Peace Pagoda.

Other activities within walking distance (or a short taxi ride) include Devil’s Falls and the Gupteshwor Cave, a Tibetan village, beautiful riverine scenery and suspension bridge at the Powerhouse, the International Mountain Museum and the leprosy hospital.

Goh, Kai XingFor the more adventurous among us, there was also paragliding and white water rafting.

In the evenings, we hung out and played games at the house.

We also visited the Movie Garden for an outdoor experience, and enjoyed some drinks and live music at bars along Lakeside.

There was always loads to do, and plenty of housemates to enjoy it with!

The trips I took on the weekend with my new friends resulted in some of the highlights of my trip.

Goh, Kai XingFor one, we got up close to rhinos, crocodiles and elephants in Chitwan National Park.

We went trekking too, at both the Australian Base Camp and the top of Poon Hill, we felt as though the snow-capped mountains were within arm’s reach.

For a bit of relaxation, we soaked in hot springs next to a raging river at Jinudanda.

 

Some final thoughs

My trip with Work the World was a wholesome experience. I met some incredible people and they were all so welcoming.

Goh, Kai XingI came home with a great appreciation of the healthcare Australia is able to provide.

I stepped out of my comfort zone and explored the natural beauty which Nepal boasts.

Don’t be afraid to meet new people and try new things. I had no trouble filling my six weeks in Nepal with unforgettable experiences.

I highly recommend you take a trip to Pokhara, especially if you’re looking for an eye-opening, educational, and exciting adventure.

Regardless of where you pick, Work the World will do an amazing job of organising and overseeing your elective placement.

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